Artasia Bobo, 16, hugs her three-year-old daughter after the teen's cheerleading practice at Itawamba Agricultural High School near Fulton, Miss., Aug. 15, 2012. Artasia's mother Renee Bobo, left, said her daughter hid the pregnancy for five months.

TUNICA, Miss. — During the four years Ashley McKay attended Rosa Fort High School in Tunica, Miss., her sex education consisted mainly of an instructor listing different sexually transmitted diseases. “There was no curriculum,” she says. “The teacher, an older gentleman who was also the football coach, would tell us, ‘If you get AIDS, you’re gonna die. Pick out your casket, because you’re gonna die.”

The scare tactic backfired. Baby showers were frequent occurrences during her time at Rosa Fort. McKay, now 24 and executive director of the non-profit Tunica Teens in Action, says between 15 and 20 students in her graduating class of 106 already had children, and that just included the girls. Marilyn Young, the president of the district’s school board, agreed the district had no formal approach to teaching sex education when McKay was a student—a gap she and others are working hard to change.

Located in the northwestern corner of Mississippi, Tunica County posted the highest teen birth rate in the state in recent years, according to data from the Mississippi State Department of Health. The state, meanwhile, consistently posts the highest teen birth rate in the country. In 2011, 55 of every 1,000 teenage girls in Mississippi gave birth, compared to a low of 16 per 1,000 in New Hampshire.

But a new law aims to improve sex education in Mississippi—or at the very least make every public school district in Mississippi start teaching it. The law lets districts choose from several curricula and decide which grades should teach sex education. For now, all of the districts in Mississippi appear to be focusing on middle and high school. About half of U.S. states mandate some sort of sex education.

The Mississippi law puts some severe restrictions on schools, however. They must, for example, allow families to opt out of sex education. Boys and girls must be taught separately. And instructors cannot show students how to put on a condom or discuss abortion. While a majority of the state’s districts have selected “abstinence-only” curricula—which typically do not include detailed information on condoms and contraceptives—a sizable minority, including the district in Tunica, have opted for curricula that include such information and come with a stamp of approval from the U.S. Department of Health and Human Services (HHS). That means thousands of Mississippi schoolchildren likely will be taught a thorough and factual sex education curriculum for the first time ever.

“The kids in Mississippi have not been given medically accurate information about pregnancy and STDs,” says Jamie Bardwell, director of programs at the Women’s Fund of Mississippi, which advocates on issues affecting the state’s women and girls, including teen pregnancy. “Once we give them access to medically accurate information, we think behavior will change and the teen pregnancy rate will go down.”

Bardwell and other youth advocates and educators hope improved sex education will make a difference for Mississippi’s teens in the short term while they work to expand health care access and economic opportunity in the long term. The state’s child poverty rate—which is positively correlated to teen pregnancy—rose to 33 percent from 26 percent between 2000 and 2010, according to data from the Annie E. Casey Foundation. No state has a larger percentage of children living in poverty than Mississippi.

But better information won’t change the fact that many Mississippi teens have comparatively restricted access to birth control and abortion. Some Mississippi drug stores keep condoms under lock and key—although it’s unclear if store owners are trying to limit access or prevent shoplifting—and the rural nature of the state makes it difficult for teens to solicit medical or moral advice about sex anonymously since the local pharmacist or pastor very likely knows their parents. Meanwhile, the state’s Republican governor and legislature have set their sights on closing Mississippi’s lone remaining abortion clinic. Thirty years ago, 14 clinics performed abortions in Mississippi.

Revamping the curriculum

Across the country, the teenage pregnancy rate has been declining for decades, a trend experts attribute to improved access to contraceptives as well as to young people delaying having sex longer than they did in the 1990s. There’s also less stigma associated with talking frankly and publicly about sex and contraception. From 2005 to 2008, the nation’s teen pregnancy rate dropped 37 percent, according to data from the Guttmacher Institute, which works to promote sexual and reproductive health. But progress has been slower in Mississippi, where the teen pregnancy rate fell 20 percent during the same period, the smallest decline of any southern state.

Teen pregnancy in Mississippi is a problem that affects the entire state and cuts across racial and socioeconomic lines, depressing the state’s already low graduation rates. Studies have shown more than two-thirds of teenage mothers do not graduate from high school. Moreover, the children of teen parents also graduate at lower rates, and earn less income, than their peers. One report by the Women’s Fund estimated that Mississippi taxpayers paid $155 million in 2009 from costs associated with births to teens—costs that included school failure, child neglect, and underemployment.

This fiscal reality helps explain why the culturally conservative state is taking steps to reduce teen pregnancy rates. Virtually overnight, the new law and a grassroots campaign led by a small non-profit called Mississippi First have revamped the way Mississippi schools teach sex education. In the past, most of the state’s 151 districts had no formal approach. When the Mississippi Department of Education asked districts for copies of their sex education policies or curricula in 2010, only five had anything written down, according to staff at Mississippi First. At many schools, the entire curriculum consisted of brief seminars with local pastors who preached the sins of pre-marital sex. Others failed to broach the subject at all.

The state law passed in 2011 required school districts to select and begin teaching a sex education curriculum by this school year. Districts can choose between several abstinence-only and abstinence-plus curricula approved by the state’s department of education—but only some of these programs are considered “evidence based” by HHS.

Mississippi First, which advocates on such issues as early childhood education and teen pregnancy, set out to encourage districts—especially those with the highest teen pregnancy and STD rates—to adopt the most comprehensive and scientific sex education possible under the new law. As an incentive, most districts that selected an evidence-based approach received free curricula and teacher training through a federal grant.

Tunica was a fairly easy sell. There, the abstinence-plus advocates had support not only from recent graduates like McKay, but also from Young. “Just talking about abstinence is not enough,” Young says. “The data provided us with evidence what we were doing was not working.”

“Some Very Tough Fights”

Not all districts were willing to venture beyond abstinence. Just under half of the state’s districts selected an abstinence-plus curriculum. Of those, 39 (or about a quarter of districts in the state) selected a curriculum endorsed by HHS. Curriculum providers typically do not release copies of their materials to the media, so it’s impossible to know precisely which topics will be covered—and which will not be—in Mississippi health classes this school year. But it’s safe to say that most of the sex education classes will strongly emphasize delaying sex until marriage. One curriculum even concludes with a mock wedding ceremony. And only the ones endorsed by HHS are likely to include comprehensive and accurate information about birth control and condoms.

“We had some very tough fights at some school districts,” says Rachel Canter, the executive director of Mississippi First, who wanted districts to choose evidence based curricula. Her colleague Sanford Johnson targeted Hollandale School District in the Mississippi Delta with a particularly aggressive campaign. Washington County, where Hollandale is located, posts more cases of teenage gonorrhea per capita than any other county in the state. But a majority of the Hollandale School Board decided that an abstinence-only curriculum would best serve the needs of its students.

“My personal beliefs are simple,” says Demetric Warren, a Hollandale board member. “I believe in the Bible,” and abstaining from sex before marriage “is a tenet of the Bible.”

He argues that advocacy groups like Mississippi First inappropriately discount abstinence-only curricula without trying them first. “The majority of school districts weren’t even dealing with sex education,” he says. “How can something fail if it hasn’t been implemented?…I have not seen a person who is not sexually active contract a sexually transmitted disease.”

The research on sex education is hotly disputed. But several peer-reviewed studies have found comprehensive that sex education is more effective at reducing teen pregnancy rates than abstinence-only approaches. One 2008 study published in the Journal of Adolescent Health, for instance, reported that teenagers who received a thorough sex education were significantly less likely to become pregnant than those who received no sex education. The study, which controlled for such factors as income and family structure, found no similar effect for abstinence-only education.

The most popular sex education curriculum in Mississippi is called “Choosing the Best.” Sold by an Atlanta-based company whose website describes it as “abstinence centered,” the program has been placed on both the abstinence-only and abstinence-plus lists approved by the state’s department of education.

State officials said the law was written in a way that allowed some curriculum to qualify as both abstinence-only and abstinence-plus since the bill offered little detail on the extent to which an abstinence-plus curriculum must discuss contraception. A spokeswoman for Choosing the Best said in an e-mail that its curriculum includes “medically accurate, complete information about the effectiveness and limitations” of different contraceptive methods. In sample pages of the curriculum she supplied, students were given fill-in-the-blank questions such as this one about all the things that can go wrong with a commonly used contraceptive: “Condoms are made of rubber, so they can _____, slip off, be affected by heat and cold, and deteriorate over time.” (The correct answer is “break.”)

But Monica Rodriguez, the president of the Sexuality Information and Education Council of the United States, says Choosing the Best does not belong in the abstinence-plus category. “What little information there is on contraceptives is not something that would give young people good information to use to make health decisions,” she says.

Yet even critics of an abstinence-only approach prefer Choosing the Best to the Denver-based WAIT (Why Am I Tempted) Training, a curriculum from the Center for Relationship Education (CRE) that some health professionals and women’s advocates have described as misogynistic and medically inaccurate. About ten Mississippi districts opted to use WAIT Training, including Tupelo Public Schools, one of the largest districts in the state.

CRE does not release full copies of its curriculum to the press. But a reporter for the Denver Westword newspaper who wrote a 2011 story about WAIT obtained videos of one of the trainers teaching an auditorium of teenagers. During one part of the presentation, the trainer, Shelly Donahue, applied the same piece of tape to the arms of different male students, ripping the tape off each teenager’s arm in turn. She likened the tape to teenage girls who engage in pre-marital sex: they become dirtier, more germ-ridden, and less able to adhere to someone the more partners they have, she said. In another controversial (and biologically questionable) part of the lesson, she said teenagers are so fertile a girl’s vagina becomes like a “little Hoover vacuum” — Donahue accompanied the phrase with a quick sucking sound — whenever sperm come anywhere near it. “You’re very fertile right now,” Donahue said, gesturing toward the high schoolers in the audience. “What happens when two fertile kids get together? How do you spell child support?”

Joneen Mackenzie, the founder of CRE, says WAIT Training includes information on contraception, but focuses on teaching kids “about love and how to have a healthy relationship.” She describes it as an antidote to “curriculum that come in with condoms, and dildos, and baskets, and makes the case for normalizing teen sex.” She adds that every activity included in WAIT Training has been “focus-grouped” by kids. “When people say, ‘You want to frighten and shame kids,’ that drives me crazy,” she says.

But others argue the curriculum shames young people—particularly girls—by implying they are dirty and ruined if they engage in pre-marital sex. “Not only is [the curriculum] not evidence-based, it’s damaging to women and girls,” says Carol Penick, executive director of the Women’s Fund.

Polling the Parents

What kind of information do families want their children to receive in school? More Mississippi parents than policy makers appear to support abstinence-plus sex education than abstinence-only. In a 2011 survey of 3,600 Mississippi public school parents commissioned by the Center for Mississippi Health Policy, most parents said they wanted a comprehensive sex education curriculum. Although 90 percent of parents saidschools should talk about the benefits of abstaining from sex, 78 percent said they wanted instruction on birth control methods; two-thirds said health instructors should tell teenagers where to obtain contraceptives; and more than half said they would prefer condom demonstrations in class.

Over the past year, Mississippi First’s Johnson has traveled throughout the state—first to convince school districts to adopt an evidence-based curriculum, and more recently to convince parents to let their children attend the classes.

Johnson has little difficulty winning over most of the parents who come to his presentations. Last month, at an evening gathering in Greenville, in the Mississippi Delta, he told the assembled parents that they live in a “priority one” community because of its high rates of gonorrhea, syphilis, and HIV.

“There are a lot of students who are virgins,” he said. “They might wait until next week to have sex. They might wait until next month. Or they might wait until their wedding day. But there are students in middle school who, believe it or not, are already sexually active.”

Johnson outlined the major topics covered in the new abstinence-plus curricula adopted in Greenville—from teaching students refusal skills to telling them how to put on a condom (but not showing them, since hands-on demonstrations are explicitly prohibited under the new law). The Greenville schools would be using the new curricula with its sixth through ninth graders, but only the older children would learn about birth control and contraceptives.

Eshaela Smith, one of only a dozen parents who attended the meeting, says she had no problem signing her seventh-grade daughter up for sex education classes. “I would like her to be educated,” she says. “But I will continue to do my part at home and pray that she’ll come to me with any questions about what she’s learning.”

MORE:How to Bring An End to the War Over Sex EThis story was produced by The Hechinger Report, a nonprofit, nonpartisan news organization based at Teachers College, Columbia University. Sarah Carr, a contributing editor at the Hechinger Report, is the author of Hope Against Hope, which tells the story of the New Orleans schools post-Katrina.